Provider Demographics
NPI:1669097036
Name:A CONSCIOUS PEACE LLC
Entity type:Organization
Organization Name:A CONSCIOUS PEACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CANNADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-353-9020
Mailing Address - Street 1:917 N SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5976
Mailing Address - Country:US
Mailing Address - Phone:913-353-9020
Mailing Address - Fax:
Practice Address - Street 1:22450 S HARRISON ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:KS
Practice Address - Zip Code:66083-3151
Practice Address - Country:US
Practice Address - Phone:913-353-9020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4406OtherKANSAS BEHAVIORAL SCIENCE REGULATORY BOARD